This invention relates to the performing of vaginal and cervical examinations and more particularly to an apparatus to be used in combination with a vaginal speculum to retract vaginal lateral walls during a vaginal examination.
It is known in the art relating to vaginal and cervical examinations to use a vaginal speculum to enlarge the passage through the vagina for gynecological examination, sampling or treatment. Problems arise when conducting visual vaginal and cervical examinations with a conventional two-bladed vaginal speculum on women who are obese, elderly, have excess adipose vaginal tissue, or otherwise poorly toned vaginal walls.
It is often impossible to obtain a complete view of the cervical area and/or impossible to collect valid PAP smear samples because the vaginal walls"" excess or relaxed tissue structure of the lateral vaginal walls pushes back in under the speculum blades after the speculum is opened. To overcome this problem, the clinician usually has to insert a pair of metal, surgical, lateral wall retractors inside of the opened speculum. These lateral retractors are expensive and clumsy, and thus nonconducive to single patient use and sampling.
Several other techniques have been unsuccessfully used to solve this problem. For example, condoms or portions of surgeon gloves have been placed over the closed speculum blades before insertion into the vagina. Unfortunately, the condom often simply rolls or slides up the blades during insertion, bunching up, rendering it useless. Further, the condom usually does not have enough force, when the blades are opened, to hold back the vaginal lateral walls. Furthermore, the condom may slip off when the blades are being removed and be left behind in the vagina. Therefore, there is a need for a device that can be used with a vaginal speculum to retract the vaginal lateral walls and which is also disposable, reliable, and cost effective.
The present invention provides a vaginal lateral walls retractor for use with a two-bladed vaginal speculum during vaginal or cervical examinations. The walls retractor includes a generally tubular sleeve that has cross-sectional dimensions that allow the sleeve to fit between the blades of the speculum while the blades are inserted and opened within the vagina. The sleeve retracts the vaginal lateral walls that have pushed in under the inserted and opened speculum blades. The cross section also provides an inside working area for examination and sampling of the vagina and cervix area.
In one embodiment of the present invention, the sleeve has a length that is about 60% of the length of a blade of the speculum. A handle extends from one end of the sleeve for manipulation by a health care provider. The handle has a length that allows full placement of the sleeve down to and around an outer diameter of the pendulous cervix and allows the sleeve to be pushed toward and away from anterior and posterior vaginal fornix and allows rotation of the sleeve inside the speculum blades.
In another embodiment, the cross section is of a generally rectangular shape with rounded corners. The sleeve has four sides and may have two cutouts on opposing sides at a proximal end of the sleeve so that an ectocervical scraper lobe will not hit the end of the sleeve. The cutouts may be of a generally elliptical shape. The sleeve may include a notch to accommodate a light pipe channel on a disposable speculum. The sleeve may be made of a plastic or metal material.
The present invention also provides an enhanced method of performing a vaginal or cervical examination on a patient. Thereby, blades of a vaginal speculum are inserted into a vagina. Once they are inserted, the blades are opened. Next, a vaginal lateral walls retractor defined by a generally tubular sleeve is inserted in between the opened speculum blades for retracting the vaginal lateral walls. To gain additional wall retraction, the vaginal lateral walls retractor sleeve is of an elongated rectangular shape. The rectangular sleeve is inserted with its longest cross-sectional dimension between the speculum blades and then rotated 90 degrees. Finally, the vaginal and cervical areas are examined and samples may be taken or treatment given.
These and other features and advantages of the invention will be more fully understood from the following detailed description of the invention taken together with the accompanying drawings.